A Rare Case of a Primary Non-parasitic Splenic Cyst Removed via Laparoscopic Intervention.

Splenic cysts are differentiated into primary and secondary cysts based on epithelial lining. Primary non-parasitic epithelial splenic cysts are extremely rare. We report a case of a 24-year-old male with left hypochondrial swelling with no history of abdominal trauma.

Laparoscopic excision of a large retroperitoneal cyst: Case report and literature review.

Retroperitoneal cysts, a rare surgical phenomenon, present diagnostic challenges due to their typically asymptomatic nature. A 62-year-old male presented with a 4-month history of abdominal distension and increased burping. Upon clinical examination, a soft, distended, nontender abdomen with a palpable mass extending from the epigastric region to 3 cm below the umbilicus was revealed.

Brucellosis As a Cause of Intestinal Perforation.

Brucellosis is a multisystem zoonotic infection. Patients usually presents with fever and nonspecific systemic symptoms but may rarely present with clinical presentation of an acute abdomen. In this case report, we present a 32-year-old male who presented to the emergency department with symptoms of acute abdomen.

Mesenteric Ischemia due to Thrombosis Involving the Aorta, Celiac Artery, and Superior Mesenteric Artery in a Young Female with Protein C Deficiency.

An arterial thrombus affecting the descending aorta, celiac artery, and superior mesenteric artery at the same time, resulting in mesenteric ischemia and splenic infarction, is a very rare phenomenon. We report a case of a 35-year-old, unmarried female, gravida 0 para 0, who presented with abdominal pain, vomiting, and constipation for two days. Computed tomography (CT) scan showed thrombi in the descending aorta to the celiac axis and superior mesenteric artery with splenic infarction, bowel ischemia, hepatic portal venous air, and uterine fibroid.

Occult Pneumothorax: What Do We Need to Do?

Occult pneumothorax is a condition in which a patient's clinical examination and chest radiograph are normal; but there is pneumothorax on computed tomography (CT) scan. We here describe two cases of trauma whose initial survey and chest X-ray showed normal lung markings bilaterally; but CT scan done subsequently, showed pneumothorax which was managed by chest intubation. There is still an ongoing debate about the management of occult pneumothorax.

Burnout among surgical residents in a lower-middle income country - Are we any different?

Objective: To assess the presence of burnout among surgical residents working at various public sector hospitals in Pakistan.

Design: A survey based on MBI was used to assess the presence of burnout. Residents were grouped into Group A (Burn out) or Group B (No burn out).

Foriegn Body In Rectum: An Unusual Case.

Rectal Foreign bodies have been reported in literature since long. They are inserted as a result of erotic behaviour. Rectal foreign bodies may be inserted as a result of sexual perversion or for nonsexual reasons such as constipation, concealment or in psychiatric patients1.

Hemoperitoneum Due to Warfarin Toxicity Presenting as Intestinal Obstruction.

The patients on anticoagulation therapy especially warfarin can develop gastrointestinal bleed, gum bleeding, hematuria or ecchymosis. Rarely do such patients present with hemoperitoneum producing symptoms. Hemoperitoneum can produce shock, cause compression symptoms or may even be fatal.

An Unusual Cause of Right Iliac Fossa Pain: Caecal Diverticulum Perforation.

Caecal diverticulum perforation is a rare condition. It mimics acute appendicitis and is seldom suspected pre-operatively. Commonly it is discovered during exploration.

Jejunal diverticulosis presenting as an acute emergency.

Diverticulosis of jejunum is a relatively rare disease of bowel. Jejunal diverticula are false diverticula with projections of mucosa and serosa without the muscular layer. These manifest as diverticulitis, bleeding, perforation or intestinal obstruction.

Use of box simulators for improving intraoperative laparoscopic skills - an essential tool for the surgeon in training.

Objective: To compare the improvement of intraoperative laparoscopic skills by measuring GOALS score between residents who have undergone simulator training with those who have not received any simulator training.

Study Design: A randomized controlled trial.

Place And Duration Of Study: Department of Surgery, Services Hospital, Lahore, from August 2013 to February 2014.

Gossypiboma as a cause of intestinal obstruction.

Gossypiboma / textiloma / retained surgical sponge is an avoidable surgical complication which can lead to patient morbidity, mortality and profound medicolegal implications. Retained surgical sponge can present early as abscess formation and septic complications or follow a silent course for many years to present later as intestinal obstruction, fistula formation or simply be extruded through rectum. A lady presented 8 months after laparotomy with symptoms of bowel obstruction due to a retained surgical sponge that had eroded into the rectosigmoid junction.